10 Changes You Should Be Aware Of Before Buying Health Insurance

Health insurance is an essential aspect of one’s future as well as health planning. It is utterly beneficial in times of unanticipated sickness or accident as it covers certain aspects related to treatment of both. 

Furthermore, insurance provides tax benefits that make it a crucial aspect of one’s tax and financial planning. Let us read more about the changes that have been introduced. 

What Are The Changes IRDAI Introduced Related To Health Insurance?

Recently, the Insurance Regulatory and Development Authority of India introduced changes in the existing rules and regulations related to health insurance. Let us have a look at them!

No Age Bar

Previously, there existed an age bar for new entrants or new buyers of health insurance policies. The age bar of 65 years has now been removed by IRDAI and the regulator has asked insurance companies to provide health insurance schemes for people of all age groups. 

This is extremely beneficial for senior citizens who can now save money and access senior citizen healthcare insurance benefits without any age limit. 

Waiting Period Of Pre- Existing Diseases

The waiting period of 4 years to seek mediclaim benefits as well as healthcare under health insurance has been ejected and the waiting period has been reduced to 3 years. This will facilitate access to treatment facilities for the elderly. 

Most importantly, the reduction in the waiting period will prevent and prohibit insurance companies from refusing to pay PED claims after the 3 years waiting period. 

Option To File Multiple Claims

The regulator has now allowed policyholders to file multiple claims with different insurers in case they hold multiple insurance policies. This would entitle the beneficiaries to choose from multiple options and seek the best option in case of diagnosis. 

Indemnity Policies Done Away With

IRDAI has directed insurance companies to stop issuing indemnity-based policies and pay a fixed sum in events of covered disease diagnosis. The regulator has asked the companies to issue only ‘benefit’ based health insurance policies to its policyholders. 

Moratorium Period

The Insurance regulator has reduced the moratorium period from 8 years to 5 years. This comes as a huge sigh of relief for policyholders since insurance providers will not be able to reject claims in case of non-disclosure of a pre-existing disease when there has been continuous coverage for 5 years. 

However, an exception has been imposed in cases where claims constitute fraud. 

Grievance Redressal Mechanism

The IRDAI has asked insurance companies to create proper mechanisms of claims and grievance redressal for the elderly. This is aimed at facilitating the process of making insurance claims and settling such grievances timely. 

Customised Plans

The insurers have been directed by the regulator to formulate customised policies for children, maternity undergoing subjects and the elderly. This way, the customers can choose from a variety of options and select the best health insurance policy for themselves. 

No Sub-Limits On AYUSH Treatment

The sub-limits that were previously imposed on seeking AYUSH treatments have been lifted by IRDAI. Now, the policyholders will be able to extract claims up to the insured sum for seeking treatment under any AYUSH healthcare treatment. 

Inclusivity By Issuing Policies To Severely Diseased

People with severe or extreme medical conditions will now be able to buy insurance plans for themselves with ease since IRDAI has now prohibited from refusing medical insurance policies to people with severe health conditions. This promotes inclusivity and equity amongst the masses. 

Waiting Period For Specific Diseases

The waiting period for specific diseases has been reduced from 4 years to 3 years. Specific health conditions such as those requiring orthopaedic treatment will now be subject to claims after a waiting period of 3 years. 

Conclusion

Health is a top priority for everyone. By introducing these changes in the health insurance sector, IRDAI has made the policies more pro-customers and inclusive in approach. These changes are expected to bring a positive change in the way both the stakeholder approach helps insurance. 

To get new information regarding IRDAI or Insurance-related news, check out our insurance category containing valuable information for you. 

For more information, access the IRDAI’s Circular here and read more about IRDAI’s rules and regulations by reading Jaagruk Bharat’s article on IRDAI’s New Rules. 

For queries and grievances, drop a mail at irda@irdai.gov.in.